Small bowel obstruction caused by massive (>250) ascariasis worms in adult female patient, a case report.

Introduction And Importance: Intestinal obstruction from ascariasis is a rare but fatal surgical emergency in endemic areas, such as Ethiopia. Reports of ascariais causing complete bowel obstruction in adults are rare while having a high rate of morbidity and mortality. Here we present a case of a 35 years old female patient who presented with complete small bowel obstruction caused by >250 ascariasis worm.

Case Presentation: We report on a case of a 35-year-old female who presented with intermittent crampy abdominal pain of 2 days duration associated with frequent vomiting of ingested matter and failure to pass feces and flatus. The patient underwent an exploratory laparotomy for acute complete small bowel obstruction and the intraoperative finding of a volvulated viable ileum with a visible and palpable ascariasis worms in the lumen of ileum. Enterotomy was done to extract >250 adult ascariasis worms.

Clinical Discussion: There are few reports of ascariasis causing complete small bowel obstruction in adults and there is no reported case of a massive number of adult worms from one patient.

Conclusion: Though World Health Organization integrated approach, which includes sanitation, hygiene education and preventive chemotherapy brings a significant decrement on prevalence of soil-transmitted helminth, our case indicates that, clinicians should consider ascariasis as a differential diagnosis for SBO even in adult age groups.